Moreno Nina, Moore Roland S
Seed Collaborative, Inglewood, California.
Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California.
Alcohol Res. 2025 Jan 14;45(1):02. doi: 10.35946/arcr.v45.1.02. eCollection 2025.
Sociocultural characteristics, including race/ethnicity and socioeconomic status (SES), may affect individuals' attitudes and norms regarding alcohol use and treatment as well as their access to emerging health knowledge, innovative technologies, and general resources for improving health. As a result of these differences, as well as social determinants of health such as stigma and uneven enforcement, alcohol policies may not benefit all population subgroups equally. This review addresses research conducted within the last decade that examined differential effects of alcohol policies on alcohol consumption, alcohol harm, and alcohol treatment admissions across racial/ethnic and socioeconomic groups.
The authors used the following Boolean phrase search terms to assess the association between race/ethnicity and outcomes: ("alcohol policy" OR "alcohol policies") AND ("race" OR "ethnicity" OR "first nations" OR "African American" OR "Hispanic American" OR "Latino American" OR "Asian American" OR "Native American"). Association with SES was assessed using these terms: ("alcohol policy" OR "alcohol policies") AND ("socioeconomic" OR "class") AND ("effect" OR "impact" OR "outcome"). Both searches were conducted on August 28, 2023, using advanced search in seven EBSCOhost research databases: (1) EBSCO Biomedical Reference Collection: Corporate; (2) EBSCOhost E-Journals; (3) EBSCO MEDLINE Complete; (4) SocINDEX with Full Text; (5) APA PsycInfo; (6) LISTA (Library Information Sciences and Technology Abstracts); and (7) GreenFILE. Inclusion criteria for both searches were: (1) publication dates between 2014 and 2023; (2) peer-reviewed research articles; (3) data disaggregated by racial/ethnic and/or SES subgroups; and (4) English language only.
The racial/ethnic search produced 64 articles, of which 14 were reviewed as relevant to this study and 50 were excluded. The SES search generated 100 articles, of which 18 were reviewed as relevant to this study and 82 were excluded. Eight of the studies identified by these two searches overlapped (i.e., included both racial/ethnic and SES outcomes), resulting in a total of 24 articles included in this review.
Relying upon data from both U.S. and international research, the identified studies focused on differential effects of financially focused alcohol control policies (e.g., taxation and minimum unit pricing policies) as well as access/availability reduction policies (e.g., those governing outlet density, on-/off-premise sales, and establishment licensing). Several studies concluded that price increases via taxes or minimum unit pricing might be particularly effective in reducing the risk of alcohol-related harms in low-income/low-SES populations. Limitations of the present review include lack of standardization in the ways that SES was measured and the difficulty of measuring policy enforceability. Studies focused on differential effects of alcohol control policies across racial/ethnic groups demonstrated complex associations and the need to conduct further research that identifies better ways to reduce policy-induced health disparities across diverse populations.
社会文化特征,包括种族/民族和社会经济地位(SES),可能会影响个体对酒精使用和治疗的态度及规范,以及他们获取新兴健康知识、创新技术和改善健康的一般资源的机会。由于这些差异以及诸如耻辱感和执法不均衡等健康的社会决定因素,酒精政策可能不会使所有人群亚组平等受益。本综述涉及过去十年内开展的研究,这些研究考察了酒精政策对不同种族/民族和社会经济群体的酒精消费、酒精危害及酒精治疗入院情况的差异影响。
作者使用以下布尔短语搜索词来评估种族/民族与结果之间的关联:(“酒精政策”或“酒精政策们”)与(“种族”或“民族”或“原住民”或“非裔美国人”或“西班牙裔美国人”或“拉丁裔美国人”或“亚裔美国人”或“美国原住民”)。使用以下搜索词评估与社会经济地位的关联:(“酒精政策”或“酒精政策们”)与(“社会经济”或“阶层”)与(“影响”或“冲击”或“结果”)。这两项搜索均于2023年8月28日进行,使用七个EBSCOhost研究数据库中的高级搜索功能:(1)EBSCO生物医学参考文集:公司版;(2)EBSCOhost电子期刊;(3)EBSCO MEDLINE Complete;(4)全文版社会索引;(5)美国心理学会心理学文摘数据库;(6)图书馆与信息科学及技术文摘数据库(LISTA);以及(7)绿色文件库。两项搜索的纳入标准均为:(1)2014年至2023年的出版日期;(2)同行评审的研究文章;(3)按种族/民族和/或社会经济地位亚组分类的数据;以及(4)仅英文。
种族/民族搜索产生了64篇文章,其中14篇被视为与本研究相关,50篇被排除。社会经济地位搜索产生了100篇文章,其中18篇被视为与本研究相关,82篇被排除。这两项搜索确定的研究中有8项重叠(即包括种族/民族和社会经济地位结果),因此本综述共纳入24篇文章。
基于美国和国际研究的数据,已确定的研究聚焦于以经济为重点的酒精控制政策(如税收和最低单位定价政策)以及减少获取/供应政策(如那些管控营业场所密度、场内/场外销售和经营许可的政策)产生的差异影响。若干研究得出结论,通过税收或最低单位定价提高价格可能在降低低收入/低社会经济地位人群中与酒精相关危害的风险方面特别有效。本综述的局限性包括社会经济地位衡量方式缺乏标准化以及政策可执行性难以衡量。关注酒精控制政策在不同种族/民族群体间差异影响的研究表明存在复杂的关联,并且需要开展进一步研究以确定更好的方法来减少不同人群中政策导致的健康差异。